Clinical efficacy and safety profile of labetalol hydrochloride in the treatment of hypertension in pregnancy — systematic review

Wstęp Zgodnie z wytycznymi ESC/ESH, nadciśnienie tętnicze u kobiet w ciąży rozpoznaje się na podstawie bezwzględnych wartości ciśnienia tętniczego (SBP ≥ 140 mm Hg lub DBP ≥ 90 mm Hg). Głównym celem terapii jest zmniejszenie ryzyka progresji do pełnoobjawowej rzucawki i minimalizacja działań niepożądanych leczenia u dziecka. Materiał i metody Ocena efektywności klinicznej na podstawie wyników pierwotnych badań klinicznych oraz dowodów wtórnych odnalezionych w ramach przeglądu systematycznego. Systematycznie przeszukano następujące bazy informacji medycznej: Medline, Embase, Cochrane Library i inne. Wyniki Ostatecznie 2 publikacje, odpowiadające przeglądowi 24 badań klinicznych oraz jednemu badaniu klinicznemu (RCT), spełniło kryteria włączenia do analizy efektywności klinicznej. Labetalol powoduje obniżenie wartości ciśnienia tętniczego w ciągu około 30 minut po padaniu leku. Leczenie labetalolem było rzadziej związane z niedociśnieniem lub potrzebą cesarskiego cięcia w porównaniu z terapiami alternatywnymi (np. diazoksydem). Najczęstsze działania niepożądane labetalolu to nudności, wymioty uderzenia gorąca, lekkie zawroty głowy, kołatanie serca, duszności oraz mrowienie po ciele — zwykle o łagodnym/umiarkowanym nasileniu. Wnioski Labetalol wykazuje udowodnioną skuteczność w leczeniu nadciśnienia tętniczego u kobiet w ciąży przy stosunkowo korzystnym profilu bezpieczeństwa. Brak skutecznego leczenia nadciśnienia tętniczego kobiet ciężarnych jest zagrożeniem życia zarówno dla matki jak i dziecka.Background According to the guidelines of the European Society of Cardiology and the European Society of Hypertension, diagnosis of hypertension in pregnancy based on absolute blood pressure values (systolic blood pressure ≥ 140 mm Hg or diastolic blood pressure ≥ 90 mm Hg). The main aim of therapy is to reduce the risk of progression to full-blown eclampsia and minimizing the adverse effects of treatment in a child. Material and methods Evaluation of clinical efficacy based on the results of primary studies and secondary evidence found in the context of a systematic review. The following literature databases were searched systematically: Medline, Embase, Cochrane Library and others. Results Finally 2 publications, corresponding to the systematic review of 24 clinical studies and one clinical trial (RCT) met the inclusion criteria for the efficacy analysis. Labetalol reduces blood pressure in about 30 minutes after drug application. Labetalol treatment was associated with rarely hypotension or caesarean compared to alternative therapies (e.g., diazoxide). The most common adverse reactions of labetalol are nausea, vomiting, flushing, slight dizziness, palpitations, shortness of breath and tingling in the body — usually mild/moderate. Conclusions Labetalol has a proven efficacy in the treatment of hypertension in pregnant women with relatively favorable safety profile. Lack of effective treatment of hypertension in pregnant women is a life threatening for both mother and child

Spin-transfer physics and the model of ferromagnetism in (Ga,Mn)As

We describe recent progress and open questions in the physics of current-induced domain-wall displacement and creep in (Ga,Mn)As. Furthermore, the reasons are recalled why, despite strong disorder and localization, the p-d Zener model is suitable for the description of this system.Comment: 13 pages, 1 figure, to be published in J. Magn. Magn. Materials, section "Current Perspectives

SAFETY OF OMBITASVIR/PARITAPREVIR/RITONAVIR+DASABUVIR IN CHRONIC HEPATITIS C PATIENTS WITH HCV GENOTYPE 1 INFECTION

Introduction The assessment of the safety profile of ombitasvir/paritaprevir/ritonavir+dasabuvir in adult chronic hepatitis C patients with confirmed HCV genotype 1 presence. Material and method Evaluation of clinical safety based on the results of primary studies found in the systematic review. The following literature databases were searched: Medline, Embase, Cochrane Library and others. Results Finally two clinical trial met the inclusion criteria. The study included untreated patients (SAPPHIRE I) or patients after unsuccessful therapy (SAPPHIRE II), with genotype 1 infection. In patients without prior treatment the prevalence of the reported adverse events was in general statistically significantly greater in the group on therapy 3D+RBV compared to the placebo group. No statistically significant differences were observed in relation to the risk of serious adverse events or therapy discontinuance due to adverse events. In patients after unsuccessful therapy the prevalence of the reported adverse events was statistically significantly greater in the group on therapy 3D+RBV compared to the placebo group. During the 3D+RBV itching was statistically significantly more frequently reported in the placebo group. Compared to the other adverse events, no statistically significant differences were observed. Conclusions Interferon-free therapies provide a safe therapeutic option in the population of adult patients with chronic genotype 1 hepatitis C, both those untreated and after unsuccessful two-drug PegIFNα-based therapy, patients with HIV co-infection and patients after liver transplantation

COMPARISON OF PERSONALIZED AND STANDARD PROPHYLAXIS BASED ON OCTOCOG ALFA IN PEDIATRIC PATIENTS WITH HEMOPHILIA A

Comparison of personalized and standard prophylaxis prevention therapies based on octocog alfa in pediatric patients with hemophilia A. Studies on a general population (adults and children) demonstrate a statistically significant advantage of personalized prevention therapy over standard prophylaxis prevention therapy in terms of annual bleeding rate (ABR) and annual joint bleeding rate (AJBR) while studies on a pediatric population included insufficiently large populations, however, their results demonstrate a numerical advantage of personalized approach over standard prevention strategy prophylaxis regimen

Analysis of the Thermal Retrofitting Potential of the External Walls of Podhale’s Historical Timber Buildings in the Aspect of the Non-Deterioration of Their Technical Condition

The paper discusses thermal quality improvement in historic buildings. It is based on a case study of a wooden historical building in an architectural style typical of Zakopane, located in the Podhale region of Poland. The building’s historical value and timber structure prevent the application of typical thermal retrofitting solutions. This paper presents an analysis of the possibilities of the improvement of energy performance of a historic building (villa) which included: a review of the available energy performance improvement solutions applicable to this type of building, with a particular focus on applying internal insulation; a technical condition assessment using non-invasive methods, the identification of problematic areas in terms of the thermal retrofitting of buildings with timber walls and decks; in situ tests: thermovision tests which showed the places with temperature distribution field disturbances in the building’s envelope, focusing on thermal bridges; measurements of actual thermal transmittance coefficients for extant partitions; measurements of the building’s airtightness and the microclimate in selected rooms; numerical analysis: an assessment of the influence of the thermal bridges on the building’s existing condition, an analysis of water content changes in wall systems post-insulation. The presented approach enables the improvement of the energy performance of timber historical buildings while preserving the historical value of its architecture. It is innovative because it tries to fill in a research gap concerning a lack of relevant guidelines in Poland. The research questions that the authors asked were as follows. Is it possible to improve the thermal insulation of a building’s wooden walls without adversely affecting the building’s technical condition? With regard to the necessity to meet nZEB (nearly zero energy building) standards, is it feasible to improve the timber walls of historical buildings? The study found that under the correct assumptions and while maintaining a responsible approach to design, it is possible to improve the energy performance of historical buildings without interfering with historical heritage

Analysis of the Thermal Retrofitting Potential of the External Walls of Podhale’s Historical Timber Buildings in the Aspect of the Non-Deterioration of Their Technical Condition

The paper discusses thermal quality improvement in historic buildings. It is based on a case study of a wooden historical building in an architectural style typical of Zakopane, located in the Podhale region of Poland. The building’s historical value and timber structure prevent the application of typical thermal retrofitting solutions. This paper presents an analysis of the possibilities of the improvement of energy performance of a historic building (villa) which included: a review of the available energy performance improvement solutions applicable to this type of building, with a particular focus on applying internal insulation; a technical condition assessment using non-invasive methods, the identification of problematic areas in terms of the thermal retrofitting of buildings with timber walls and decks; in situ tests: thermovision tests which showed the places with temperature distribution field disturbances in the building’s envelope, focusing on thermal bridges; measurements of actual thermal transmittance coefficients for extant partitions; measurements of the building’s airtightness and the microclimate in selected rooms; numerical analysis: an assessment of the influence of the thermal bridges on the building’s existing condition, an analysis of water content changes in wall systems post-insulation. The presented approach enables the improvement of the energy performance of timber historical buildings while preserving the historical value of its architecture. It is innovative because it tries to fill in a research gap concerning a lack of relevant guidelines in Poland. The research questions that the authors asked were as follows. Is it possible to improve the thermal insulation of a building’s wooden walls without adversely affecting the building’s technical condition? With regard to the necessity to meet nZEB (nearly zero energy building) standards, is it feasible to improve the timber walls of historical buildings? The study found that under the correct assumptions and while maintaining a responsible approach to design, it is possible to improve the energy performance of historical buildings without interfering with historical heritage

The long-term efficacy of tick-borne encephalitis vaccines available in Europe - a systematic review

Abstract Background Despite the availability of vaccination, TBE (tick-borne encephalitis) remains a global public health problem. Therefore, the aim of our study was to assess the long-term efficacy of vaccinations against tick-borne encephalitis using vaccines available on the European market. Methods The analysis was conducted on the results of a systematic review conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. The search was performed in three databases, namely Medline (via PubMed), EMBASE (via Ovid), and the Cochrane Library database. The authors followed the PRISMA method and the selection of the articles was performed with two independent researchers. Results From a total of 199 citations, 9 studies were included in this review. According to the primary studies identified in the search, the efficacy of available anti-TBE vaccines ranges from 90.1% to 98.9%; however, in individuals above the age of 60, the protection wanes as early as one year after vaccination. Administration of a booster dose 3 years after completion of the basic vaccination schedule significantly extended the period of protection against TBE. Conclusions Anti-TBE vaccines available in Europe have a high level of efficacy. However, the level of protection against TBE is decreasing after vaccination. Therefore, in addition to the conventional schedule, booster vaccines should be administered every 5 years in individuals before the age of 60 and more frequently, e.g. every 3 years, in individuals aged 60 and beyond

The Usage of Cryopreserved Reproductive Material in Cancer Patients Undergoing Fertility Preservation Procedures

Background: Many cancer treatment methods can affect fertility by damaging the reproductive organs and glands that control fertility. Changes can be temporary or permanent. In order to preserve the fertility of cancer patients and protect the genital organs against gonadotoxicity, methods of fertility preservation are increasingly used. Considering that some patients ultimately decide not to use cryopreserved reproductive material, this review analysed the percentage of post-cancer patients using cryopreserved reproductive material, collected before treatment as part of fertility preservation. Methods: A systematic search of studies was carried out in accordance with the Cochrane Collaboration guidelines, based on a previously prepared research protocol. The search was conducted in Medline (via PubMed), Embase (via OVID), and the Cochrane Library. In addition, a manual search was performed for recommendations/clinical practice guidelines regarding fertility preservation in cancer patients. Results: Twenty-six studies met the inclusion criteria. The studies included in the review discussed the results of cryopreservation of oocytes, embryos, ovarian tissue, and semen. In 10 studies, the usage rate of cryopreserved semen ranged from 2.6% to 21.5%. In the case of cryopreserved female reproductive material, the return/usage rate ranged from 3.1% to 8.7% for oocytes, approx. 9% to 22.4% for embryos, and 6.9% to 30.3% for ovarian tissue. In studies analysing patients’ decisions about unused reproductive material, continuation of material storage was most often indicated. Recovering fertility or death of the patient were the main reasons for rejecting cryopreserved semen in the case of men. Conclusion: Fertility preservation before gonadotoxic treatment is widely recommended and increasingly used in cancer patients. The usage rate is an important indicator for monitoring the efficacy of these methods. In all of the methods described in the literature, this indicator did not exceed 31%. It is necessary to create legal and organizational solutions regulating material collection and storage and to create clear paths for its usage in the future, including by other recipients

Professional activity of people with epilepsy

Background: The aim of the study was to determine the occupational activity of epileptic patients. Particular attention was paid to employment of people with epilepsy, the way the workplace is informed about the disease, impact of education on employment opportunities and the relationship between clinical type of epilepsy and professional activity. Material and Methods: Patients were recruited from the neurological outpatient clinic in Warszawa and asked to fill in a customized questionnaire, containing questions on their socio-demographic, clinical and employment status. Results: The study included 197 adult patients with epilepsy (64 professionally active and 133 inactive). As many as 47.7% of respondents declared that the disease impeded their employment, and 77.2% admitted that the occurrence of seizure at work had negatively affected their comfort. As many as 42.2% professionally active respondents had revealed the disease at work. There was a statistically significant difference between individuals with primarily generalized seizures and those with partial and secondarily generalized seizures (30.61% vs. 2.63%, p 0.05). Neither current work status had impact on opinions about difficulties in finding a job (p > 0.05). Conclusions: Epilepsy is a great obstacle to finding and maintaining employment. Less than 1/2 of patients inform the workplace about their illness, mainly due to previous negative experiences. Since education significantly enables the employment, programs aimed at promoting vocational activation of patients should facilitate access to learning. Med Pr 2015;66(3):343–35